Spectrum and frequency of illness presenting to a pediatric emergency department

Knowledge of the spectrum and relative frequencies of pediatric emergencies is an important factor in developing appropriate training curricula for pediatric residents.

To provide these data, we indexed the 11,483 consecutive patients seen in our pediatric emergency department (PED) during the year 2003.

Age ranged from 1 week to 27 years, with a mean age of 3.9+/-4.3 years. 52.7% of the visits were by children younger than 3 years, 9.5% by adolescents, and 0,1% by young adults with chronic conditions. 55.1% of the patients arrived on day shift, 32.5% on evening shift and 12.4% on night shift. 61.8% of the patients were seen during the evening/nighttime or on the weekends. 25.2%, 22.1% and 28.6% of the patients seen on night, day and evening shifts respectively were hospitalized. The most common chief complaints were fever (22.1%), upper respiratory tract infection (13.2%) and diarrhea (10%). The most common final diagnoses were upper respiratory tract infection (26.7%), viral syndrome (13.1%) and gastroenteritis (10.7%). The majority of chief complaints and final diagnoses were related to infection (63.9%).

These data may contribute to curriculum development in training of PED physicians. We especially recommend an emphasis on management of fever and infections to optimize the quality of care delivered in the pediatric emergency department.